How come it's wrong to mutilate girls in Africa in keeping with tribal ritual, but okay with to hack up boys in America in keeping with tribalistic ritual? Some woman wants to mutilate (circumcise) her eight-year-old and the kid's divorced dad is fighting back. Good for him. Judy Peres writes in the Chicago Trib:

In a case that has drawn the attention of anti-circumcision groups nationwide, doctors testified Tuesday that there is no medical justification for removing the foreskin of an 8-year-old Northbrook boy.

Dr. M. David Gibbons of Washington, D.C., a pediatric urologist, said he saw nothing in the boy's medical records to warrant circumcision, an operation he said could cause serious complications.

But the boy's pediatrician, Dr. Arnold Goldstein of Highland Park, said he believed circumcision was the "best and easiest way" to prevent problems in the future.

The boy's mother insists, on the advice of Goldstein and two other doctors, that the operation is necessary to prevent recurring bouts of inflammation, called balonitis.

His father, a building manager from Arlington Heights, is suing to block the operation, calling it an "unnecessary amputation" that could cause his son irreparable physical and emotional harm.

"If you have an infection in your finger, you don't cut it off," the father said from the witness stand. "First you try to treat it."

The parents are divorced. The Tribune is not naming them to protect the boy's privacy.

Gibbons and Dr. Robert Van Howe, a pediatrician from Marquette, Mich., said balonitis, often caused by chemical irritants, is nearly always treatable with a steroid ointment.

Goldstein admitted the boy never received a steroid. The only medication recommended was an antibiotic ointment such as Neosporin, which Goldstein acknowledged did not help. The two experts said Neosporin is not recommended for balonitis and sometimes even causes inflammation.

Goldstein also testified that the boy had a history of phimosis, or adherence of the foreskin to the head of the penis. But he conceded under cross-examination that he could not document such a history in the child's chart.

Gibbons and Van Howe testified that phimosis is normal for a child of this age.

"Sixty-five percent of 9-year-old boys still have a partially attached foreskin," Gibbons said. The boy will turn 9 next month.

"Intactivist" groups are eagerly awaiting Kaplan's ruling, which could break new legal ground.

"If the court were to rule that circumcision is not in the best interests of this child, that would set an American precedent that doesn't exist today," said George Hill, director of bioethics for Doctors Opposed to Circumcision.

In his opening statement, David Llewellyn, one of the father's attorneys, told Cook County Circuit Court Judge Jordan Kaplan that routine circumcision became popular in the 1870s in a "misguided attempt to punish and deter masturbation." But doctors now know it is rarely medically necessary, he said, and its risks outweigh its benefits.

As for claims that circumcision prevents infection, so does washing well. Can't we just teach boys to wash? Isn't it terribly barbaric to perform unnecessary surgery on an unconsenting baby just in keeping with primitive religious practices? I mean, sure, let the kid grow up and make his own decision at 25. And let's guess what that will be: "You can either have part of your dick hacked off -- or you can just wash." Hmmm, that's a toughie!

Comments

I have always hated the idea of "automatic" circumcision of boy babies. Talk about trauma.
One of my sons isn't circumcised-- his father wasn't. My other IS because HIS father insisted--for all the wrong reasons. It didn't matter that I had shared all the info refuting the need for it--he was devoted to his archaic notions.

Way to go, Andrew, guess you'd be okay with cutting off a hand for a 4000 year old fairy tale as well, if they said that's what you had to do.

Apparently, God isn't satisfied with being omniscient and omnipotent, he also wants a piece of your dick as well.

But, oh yeah, 'this is the way we've always done it' is a good enough reason to surrender your rationality for dogma. Guess you still use leeches when you get sick, also.

Homer
at June 14, 2006 10:27 PM

Amy Alkon asked that this be posted while she's away:

Because of the work we're doing to deal with the huge spam flood, my site crashed a few hours ago, and it looked like all the comments disappeared. I've actually only lost nine, from this entry on male genital mutilation (remnants are below). I'm really, really sorry.

Gregg backs up the site every morning. He backed it up this morning, so we have everything until about nine hours ago. As I'm writing this, all the comments read zero, but if you click on "link me," they're there -- except for the last eight comments, all of which were on this entry...which depresses me terribly, and sucks for all the people who left comments (below). He's rebuilding the site now to get the number to reflect the correct comments. If it's not too depressing, maybe you can repost these comments. I hope you will, but I understand if it's too disheartening. Believe me, that's how it feels to me. I'll post in below all I have left right now of the nine missing comments.

"What do you prefer Lena?" Well, actually, I've never given it a thought before now. I...

Adults can use those studies, as well as their knowledge of their own behavior and responsibility, to choose whatever they want for their own bodies. Those studies do not lead to a conclusion that circumcising children is acceptable to maybe prevent an STD (or any other disease or infection) that can be better prevented through safe sex practices. Circumcising a child for any reason other than an immediate medical condition that can't be fixed by less invasive methods is wrong.

I'll repost my comment I made just after the crash (it disappeared when Gregg restored the site with the backup, but I had pasted it into a Word doc):

MG, don't be so quick to assume I take a facile approach to this. I've been meaning to write about this for a year. I've read Dr. Franklin C. Lowe's work, and had planned to interview him, and I've read a number of books on this, as well as a number of studies other than Lowe's. In Africa, HIV transmission was reduced by circumcision, it seemed. Condoms likewise reduce transmission. As for the "less infections" notion - would you rather wash or have somebody cut off a piece of your dick that sounds like, from what I've read, it has a great deal to do with sexual pleasure. The reason for circumcision? Maimonides, for example, thought it would reduce masturbation. Would you give a baby a nose job if it didn't have a deviated septum? This is yet another way the religious nonthink has pervaded everyone's lives in a horrible way. As for the next person who wants to accuse me of taking a facile approach to subjects that pertain to my column -- bring it on.

FYI: here are a few of the news stories on the subject I have saved in my computer since 2004:

Recent research in South Africa suggests male circumcision may reduce the transmission of HIV and other STDs. In the United States, circumcision rates declined by 7.2 percent between 2001 and 2003, reaching a 50-year low of 55.9 percent, according to CDC. Even in the Midwest, which has the nation's highest rate at 77.8 percent, the procedure's popularity is in decline.
The decline may reflect the lack of medical reasons for circumcision and an increase in the population of immigrants from countries where the procedure is not performed, say health care professionals. The American Academy of Pediatrics (AAP) and other prominent medical associations do not recommend the procedure.
"I would say that all the pediatricians in town go with the academy's party line: This is a cosmetic surgery. There is no medical reason to do it," said Dr. Nancy Hansen, department of pediatrics chairperson at Riverside Methodist Hospital in Columbus. Often, cultural reasons apply. "They don't want their boys to look funny in the locker room," said Hansen.
Hygiene "really isn't a good reason to justify circumcision," said Dr. JoAnn Rohyans of Olentangy Pediatrics and spokesperson for the Ohio Chapter of AAP.

In the United States, the male circumcision rate is falling just when a gathering body of evidence suggests the procedure could reduce the transmission risk for HIV and STDs.
More than a decade ago, the American Academy of Pediatrics (AAP) stopped recommending routine circumcision, believing there is a lack of evidence it is medically necessary. And while Medicaid reimburses one-third of all circumcisions annually, sixteen states, including California, Florida and Maine, have cut such coverage. From 1993 to 2003, circumcision rates have declined from 63.5 percent to 55.9 percent. In the 1960s, nine of 10 boys were circumcised.
A recent randomized trial involving 3,200 men in South Africa found such overwhelming evidence that circumcision was associated with lower HIV risk that the study was ended early. Other smaller studies suggested the procedure protects against gonorrhea and syphilis. In 2003, a review of 2,000 male inner-city STD clinic patients found uncircumcised men were twice as likely as circumcised men to have either or both infections.
"Other than condoms and antiretroviral drugs that block transmission during childbirth, circumcision is the next best tool we have to [slow] infections," said Dr. Thomas Coates, professor of infectious diseases at University of California-Los Angeles' David Geffen School of Medicine

"How come it's wrong to mutilate girls in Africa in keeping with tribal ritual, but okay with to hack up boys in America in keeping with tribalistic ritual?"

But not everyone thinks female genital mutilation in Africa is wrong. Martha Nussbaum nicely summarized (though still opposed) the position in "Sex and Social Justice":

"The strongest argument in favor of the practice is an argument that appeals to cultural continuity. Jomo Kenyatta and others have stressed the constitutive role played by such initiation rites in the formation of a community and the disintegrative effects of interference. For this reason, Kenyatta oppposed criminalization of the surgery and recommended a more gradual process of education and persuasion."

Lena
at June 15, 2006 9:50 PM

"How come it's wrong to mutilate girls in Africa in keeping with tribal ritual, but okay with to hack up boys in America in keeping with tribalistic ritual?"

Also, most people don't understand that the difference between male and female genital mutilation is a difference in degree, not a difference in kind. We circumcise males, so it's "good". We don't circumcise females, so it's "bad".

That quote from Ms. Nussbaum could be said about our acceptance of male circumcision in America. We're not always as enlightened as we think we are.

Nussbaum also points out that female and male "genital mutilation" are not anatomical analogues:

"The male equivalent of the clitoridectomy would be the amputation of most of the penis. The male equivalent of infibulation would be removal of the entire penis, its roots of soft tissue, and part of the scrotal skin."

Lena
at June 16, 2006 5:17 PM

1/3rd less pleasure? Was that measured in shagodynes or smegawatts?

Paul Hrissikopoulos
at June 16, 2006 8:44 PM

I'd hoped to die never having said these words, but: Lena comes though like a sister.

Arguing that male circumcision costs 1/3rd of a person's sexual pleasure is preposterous. Mostly, it allows sane people to conclude that circumsision is therefore irrelevant: Fucking is SO good that the loss of 33% of feeling has no appreciable effect on masculinity. We've had a couple of generations of Americans to study for a change in behavior, but we've found no statistical impact. Boys will be boys.

Secondly, of course, feelings are always a mystery. You never know what's going on in someone else's heart. In the seventies, this was expressed by drugged, coddled white teenagers as follows: "Man, my blue could be your yellow.... But, like, we'd never know! Wow!"

"feelings are always a mystery. You never know what's going on in someone else's heart."

And there's something great about that. Because if we could every completely know another, we might stop trying to get closer. (I'm thinking of Lilly Briscoe and Mrs. Ramsey from "To The Lighthouse." Intimacy is knowing.)

Lena
at June 17, 2006 9:01 AM

I'm not a regular on this site. I only learned of what happened to my comment just now. For what it's worth, I meant to check back sooner.

Amy, I wasn't directing any part of my comment to you, but to the authors of some of the previous comments. Did I confuse one of your's with someone else's? If so, I'm sorry. Though, I can't remember whether or not that is the case, and it's no longer possible to check. Oh well.

As for those who doubt the 1/3 loss of sexual pleasure, I was referring to the amount of nerves associated with the ejaculatory trigger within the removed foreskin. Isn't it obvious that would result in reduced sensitivity? That is what I was referring to.

Pointing out that boys don't cease to be sexually active is an attack on a strawman. If it did work that way, the religious nuts who long ago made circumcision popular in America would've succeeded in ending masturbation.

I don't CARE whether loss of sensitivity changes behavior or not. It's still a loss that modern medicine can't replace. For what reason is that forced upon a child? Preventing problems that can be solved by other means? To conform? By what right?

Crid, what do you mean "feelings are always a mystery"? I was pointing out a reudction in sensitivity caused by circumcision. What are you going on about? And of course people abusing drugs have trouble articulating... Well, anything. If you were mentioning it for entertainment value, I'm not amused. If there was another reason to bring it up, it's left me scratching my head.

As for arguing that male circumcision isn't as bad as female circumcision because less is removed in the former and the method of doing so is cleaner and safer than it is for the later, I say: SO WHAT?! The lesser of two evils is still evil. Amputative surgury of any kind to any extent should only be performed when there is no alternative. Especially when the patient is unable to decide for him/herself.

One final note before I finally shut-up: In case anybody missed it, I will restate (in extended form) that those who think circucision doesn't hurt baby boys, because they don't cry, have a poor sense of observation. Otherwise, they would've noticed the reason he didn't cry was because he was too busy going into shock!

M G
at June 18, 2006 2:27 AM

"the reason he didn't cry was because he was too busy going into shock!"

That sounds possible. But how do you actually know they're going into shock? (ie, has that hypothesis been tested?)

I took out my old anatomy textbook after reading your comment about "the ejaculatory trigger within the removed foreskin." There was no mention of such a thing.

Lena
at June 18, 2006 8:27 AM

Lena,

First, looking back at my last post, I realize I perhaps read more into your previous post than I should have. If I did, I apologize. I didn't mean my response to be as accusatory as it sounds when I read it now. More so, I should've directed it at Nussbaum's comparison of male and female circumcision, not at you.

As to your most recent comment, it's amazing how many current anatomy textbooks show the circumcised penis with no explanation that the foreskin is natural. That said, much of the resarch regarding the ejaculatory trigger is recent ('90s and beyond). It involves the rigged band and how that plays a role in arousal and orgasm. Specifically, it involves the ridged band, which is removed during circumcision.

Anyway, I went to the National Library of Medicine's website (specifically, www.pubmed.gov) and searched first on "ejaculatory trigger" -- which yielded nothing. Then I searched on "ejaculatory" AND "trigger," which yielded 7 citations. Two of them reviewed the central nervous system's (ie, spinal cord's) role in ejaculation, but none of them mentioned the foreskin. The rest were about gerbils and such.

Lena
at June 19, 2006 4:41 PM

Lena, I'm sorry I didn't get back sooner. I am amazed that the NLM's site doesn't have anything more relevant than references to the spine. I found more on-topic info than that by typing "ejactulatory trigger" into MSN Search and clicking the very first result.

So much for government efficiency.

As for the baby going into shock, I again went to MSN search, typed "circumcision baby going into shock" and clicked the very first result. It was an FAQ page. Under the question "Does it hurt?" I found this:

"Yes, it hurts. The skin of the penis of a newborn baby has pain receptors completely sensitive to clamping and cutting. The myth that newborns do not feel pain came from the observation that newborns sometimes withdraw into a deep sleep toward the end of the operation. This does not mean that they do not feel pain. Falling into a deep sleep is a retreat mechanism, a withdrawal reaction as a consequence of overwhelming pain. Not only does circumcision cause pain in the penis, the newborns over all physiology is upset. New research shows that during unanaesthetized circumcision, stress hormones rise, the heart rate speeds, and valuable blood oxygen diminishes. Babies should never be subjected to the shock of unanaesthetized circumcision."(emphasis added)

Going into sleep as a defense against great pain? If that isn't shock, then I guess I don't know what the word means at all.

Notes of interest: In both cases, I used MSN Search, by default. I didn't bother trying other search engines first. I didn't bother with wikipedia. I didn't comb through the results to find what suited my argument. I went with the very first site listed each time.

I found, on the greater WWW, the info you didn't find at the NLM. I did it without any serious effort. Hell, I didn't even read through the entire FAQ page. In fact, I didn't read enough to figure out what side of the debate they're on, or if they're playing neutral.

The lesson here, aside from the main topic, is: don't ever trust government workers when you don't have to.

M G
at June 19, 2006 10:57 PM

If there were something in the peer-reviewed scientific literature on "the ejaculatory trigger," (or "chakras," or "channeling"), it would show up in the NLM database.

Lena
at June 20, 2006 6:58 AM

So Lena, you are using the "appeal to authority" argument. "If it ain't in the NLM, it must be new-age quackery." Is that what you're saying?

Peer review is great for screening out frauds and honest errors. But it isn't fool-proof. Please allow me to digress for a just moment. I have a quick point to make.

Religious creationists often mention Piltdown man in their arguments. It was "discovered" between 1908 and 1912. It was proven to be a hoax in 1953. Why did it take so long? Because, prior to 1953, although peer reviewers found the skeletons to be quite an abnominally, none of them bothered to ask if Piltdown man was simply a fraud.

Failure to ask that one question resulted in embarassment for scientists and a field day for those attacking science.

The only thing I'm trying to say, by bring this up, is: don't make "peer review" your sole criteria for evidence. Even the greatest minds can make honest mistakes, as mentioned above, or let cultural bias cloud their judgement.

To elaborate on that, as it relates to the current topic, I pulled up MSN Search and entered the search-words "peer review circumcision."

The first site listed ( http://www.circumcision.org/bias.htm ) in the results explains that peer review of circumcision typically focuses on the question of whether there are any benefits to the procedure. The question of whether any harm occurs from even a perfectly performed circumcision is ignored or avoided. To quote from that page:

Furthermore, medical researchers do not necessarily approach the literature “objectively.” They routinely cite studies that support current medical thinking and, as mentioned previously, ignore studies that conflict with that thinking. In addition, medical doctors prefer reports describing new treatments to those critical of current treatments.

But, since you've already decided in-advance that the usefulness of the foreskin is akin to new-age pseudo-science, I kept digging. I changed my search-words to "foreskin sensitivity evidence."

The first site in the results was selling "artificial foreskin." Not quite on-topic.

Some doctors who are associated with the Albert Einstein College of Medicine at Yeshiva University have carried out measurements of glanular sensitivity in both circumcised and intact males. Bleustein et al. claimed to measure overall penile sensitivity, but their methodology made that impossible. Even though the high innervation, the sensitivity, and the erogenous nature, of the foreskin had been reported previously, the foreskin inexplicably was not tested. The foreskin was held back out of the way and the contribution of the foreskin to overall penile sensitivity was not determined. Their studies reported little difference in glanular sensitivity between circumcised and intact males. If that is the case, then the decrease in penile sensitivity after circumcision and the increase noted after foreskin restoration must lie elsewhere. The most likely location is in the foreskin. Denniston reported loss of sexual pleasure in a survey of males circumcised in adulthood.(emphasis added)

To sum up: There is evidence that peer reviewers, either through intent or error, are failing to examine the sensitivity of uncircumcised foreskin and it's role in sex.

Ok Lena, now will you start doing your own homework?

M G
at June 21, 2006 12:50 AM

Uh, Lena, forget my last post. Please? Not only is it needlessly long-winded, and making a few points that can be easily misconstrued, but I wrote it while I was half-asleep. If that wasn't bad enough, I over-looked an important detail. ...and while telling you to do your homework. Oh, the shameful irony.

But I'm amending for it now.

You said you turned up nothing at the NLM after searching with the words "ejaculatory trigger." You seemed hung-up on those two words, almost as if you don't understand what they mean. I suspect you didn't bother with other search-words, such as "foreskin sensitivity" for example. So, I decided to try other keywords in the NLM database.

The web address you provided didn't work. So I had to search for it. This is what I found.

Now it was time to search the NLM myself. I used the words "foreskin sensitivity." There were nine results found in the NLM itself. None relevant. (at least, that I could tell) Another 235 hits in MedlinePlus. Why MedlinePlus was included in the search, I don't know. I do know there are many irrelevant links included there too.

Due to adverse weather, I must cut this short. You concluded the foreskin had little value in sex becasue the words "ejaculatory trigger" failed to produce hits after one search at one site. Perhaps now you can see that finding ANY information on this topic at the NLM is a pain. Like I said before: so much for government efficiency.

You were way too quick to conclude the evidence doesn't exist. That is all I'm trying to say.

M G
at June 21, 2006 6:59 AM

You attributed the lack of information on the "ejaculatory trigger" in the NLM database to government inefficiency. Then you plunged into the Internet as a resource for facts. But the Internet has no quality control. That's why it's so much fun.

The usefulness of foreskin isn't quackery, but this "ejaculatory trigger" thing may very well be.

On a personal note: If I had a son, I would not have him circumcized. Do you like me now?

Lena
at June 21, 2006 7:08 AM

The shape of the male member is important to physical "pumping" of liquids. The foreskin could have a simple role in transmitting sensation by forming a place for pressure to be transmitted to receptors without actually needing many to work - although that idea would be contradicted by pain response to an excising.
Doctors vow to "Do No Harm". Hmm.

On the lighter side, do you know why the rabbi stopped performing circumcisions ? He was tired of working for tips.

Pain is not necessarily equal to harm. Some things that harm us actually feel great momentarily.

Lena
at June 24, 2006 12:57 PM

I used to draw blood in a newborn nursery, which is traumatic enough for a baby. The fiberglass "chair" the nurses used to strap little boys into, before circumcision was stained from urination. I think circumcision to babies, even at that age is a barbaric practice. A practice almost as common as adenoids being removed, and ear tubes. Perhaps our children would be better adjusted if circumcision was performed only when medically necessary (i.e. other remedies are tried first).

Rosemary
at June 24, 2006 5:54 PM

Male circumcision is genital mutilation performed on unconsenting children. It is a violation of human rights and an assault on the defenceless. It reduces sexual pleasure for both partners. It's health benefits have been investigated by all the major medical authorities in US and Europe, and declared proven health benefits to be virtually NIL.

In the US there is a thriving market in neonatal foreskins, which are paid for by weight (think about it), with a typical one netting $100 for the doctor, who never reveals this to the parents. They are used in very high price anti-aging creams ($800 per tube). I didn't believe this either but if you dig on google with care and intelligence you will find it's true.

Finally, this is a religiously loaded topic, and there is a steady flow of propaganda trying to establish health benefits.

Much notice has been given to a recent study from Africa and France suggesting that being circumcised decreases the risk of getting HIV by 50%. Resulting in proposals to start a huge campaign of mass circumcision.

I am very concerned that this flawed study (google will find it for you) may lead to millions of africans being misled into believing that having themselves mutilated will reduce their vulnerability to aids.

I have examined the original paper and it commits the cardinal error of assuming that because two things occur together, one must be causing the other.

The relationship is almost certainly tied to geography, and hence to variations in cultural practice.

Put simply, the data shows that Aids increases as you go south, whilst circumcision increases as you go north.

These two trends could have any number of causes. Examples are - climate, missionary penetration, geographical spreading of disease or cultural practice over time from an original source.

If being circumcised actually reduced aids risk, the effect should not disappear if we group countries from the same geographical area together. Follow the link. Look at the graph yourself. Within each geographical group of ten or twelve there is no connection at all. It is a North-South effect and disappears when we group contries from similar areas.

What this means is that circumcising more africans will not reduce Aids incidence at all.

To tell them the opposite, and persuade them to mutilate themselves, would be a crime.

This whole topic gives us in the west a rare opportunity to open our own cultural blinkers, and see that our indignation at Female Genital Mutilation and its defenders is pure hypocrisy if we defend male circumcision ourselves.

The brainwashing and irrational cruelty we think we see in them - it is in us. We are the same. We are as blinded as they. For all our vaunted education.

Look at our defensive arguments. Look at theirs. where is the difference ?

Commentator
at July 22, 2006 8:11 AM

On a more personal note:
Is a foreskin valuable, or a useless accidental appendage ?

My foreskin is hugely valuable in my lovemaking with my partner, and is an essential element in my sexual technique. It is hard to explain without a diagram how evolution has designed it to function.

It is not only a cover to retain sensitivity.

It completely alters the mechanics of first penetration. Rather like the caterpillar tracks on a tank, it delays the need for any sliding until the penis is half way in. The glans only unsheaths itself when it is well inside where there is the best lubrication. Until then the only sliding is on the inside surfaces of the foreskin.

Very hard to understand or communicate without a demonstration :)

I suppose evolutionarily it gave a reproductive advantage in allowing intercourse in a more hurried situation and with no possibility of discomfort to either party through low lubrication levels.

It makes lovemaking so very much easier, and more relaxed. My partner can comfortably accept me whenever she feels mentally right, and let her body catch up at its leisure.

We really couldn't contemplate its loss.

But of course, if you've never experienced any of this, no amount of words can let you really appreciate it.

Depriving a baby of this is in my opinion, literally a crime, which should be prosecuted exactly as cutting off its hand would be.